In this study, using the HL7 protocol, we developed patient management system gateway which is composed of 2 parts; message transferring-receiving and sentcncc generating-parsing part. To make the gateway more transplantable, it was developed on the PC operated with Windows OS. To make the gateway more productive, it was developed with Visual Basic 6.0. The database was built into MS SQL. Server which is most optimized on MS Windows NT system environment. This gateway system has the advantage of easy data-exchange capability between the patient management systems of medical facility and the messages transferred can he managed systematically and he transplanted easily into PC base hospital information system.
Hospital Information Systems ; Humans

Primary signet ring cell carcinoma of the urinary bladder is a relatively rare histological variant of mucus-producing adenocarcinoma usually of poor prognosis. We report two cases of primary bladder signet ring carcinoma. The first patient underwent a radical cystectomy with ileal conduit (pT3bN1M0), radiotherapy, and chemotherapy (M-VAC regimen) and subsequently expired 37 months after surgery. The other was initially diagnosed with peritoneal metastasis from the primary bladder signet ring cell carcinoma and was treated with partial cystectomy (pT3bNOM1). Postoperative adjuvant therapy was not done because of patient's refusal.
Adenocarcinoma ; Carcinoma, Signet Ring Cell ; Cystectomy ; Disulfiram ; Humans ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder ; Urinary Diversion

BACKGROUND: It is controversial whether the presence of bullae on the contralateral lung on HRCT plays a role in occurrence of contralateral primary spontaneous pneumothorax. We analyzed the significance of bullae on the contralateral lung and the risk factors associated with contralateral occurrence of primary spontaneous pneumothorax. MATERIAL AND METHOD: Three hundred ninety four patients who were undergone Video.Assisted Thoracoscopic Surgery for primary spontaneous pneumothorax between January 2004 and December 2009 were reviewed. The clinical features, HRCT and treatment of these patients were analyzed retrospectively. RESULT: Twenty eight of 394 patients had contralateral occurrence (7.10%). The average time was 13.06+/-9.79 months. A presence of contralateral bullae of lung on HRCT may not seem to be significant for occurrence of contralateral primary spontaneous pneumothorax (p=0.059). But bullae numbers were much more in contralateral pneumothorax patients (p=0.011). Younger than 20, being underweight (Body Mass Index<18.5 kg/m2) are independent risk factors for contralateral occurrence (odds ratio, 5.075 (1.679~5.339), 2.366 (1.048~5.339) respectively). CONCLUSION: The presence of bullae on the contralateral lung on HRCT was not significantly influenced the occurrence of contralateral primary spontaneous pneumothorax. However, age, body mass index, and the number of bullae were significant factors for the contralateral pneumothorax. We suggest that those high risk patients may require special attentions and general supportive care to prevent occurrence of contralateral primary spontaneous pneumothorax during the follow-up.
Attention ; Blister ; Body Mass Index ; Follow-Up Studies ; Humans ; Lung ; Pneumothorax ; Risk Factors ; Thinness ; Thoracic Surgery, Video-Assisted ; Thoracoscopy

PURPOSE: To evaluate the clinical and radiographic findings of localized foreign body (FB) granulomas onmammograms. MATERIALS AND METHODS: This study involved 13 patients with localized FB granulomas on mammograms;their history of mammoplasty or other plastic procedures was obtained by telephone interviews. Two radiologistsanalyzed the location and morphology of FB granulomas and the presence of associated linear densities orparenchymal distortion on mammograms. Four patients underwent ultrasonography. RESULTS: No patient had a historyof mammoplasty. All 13, however, had a history of plastic procedure, three to 22 (average, 12) years previously,as follows : foreign materials including silicone liquid and oil such as paraffin been injected into the anteriorneck area of nine patients, the infra-auricular area of two, and the nose of two. Multiple small, high-density,flocculent nodules representing FB granulomas were distributed bilaterally in nine patients; they were noted inthe upper inner portion of 11 of 26 breasts. In eight patients, mammograms showed linear opacities suggestingfibrosis. There was no calcification or parenchymal distortion. Though in three cases, the masses were palpable.Ultrasonography revealed several anechoic nodules with posterior enhancement in subcutaneous fatty layers, and inone, 0.2cc of oil droplet had been aspirated under ultrasonographic guidance. CONCLUSION: Localized FB granulomasof the breast could be caused by the migration of FB from cervicofacial areas. Mammography showed characteristicdistribution of upper inner portions, and the findings were similar to those of mild interstitial mammoplasty.
Breast* ; Female ; Foreign Bodies* ; Granuloma ; Granuloma, Foreign-Body* ; Humans ; Interviews as Topic ; Mammaplasty ; Mammography ; Nose ; Paraffin ; Plastics ; Silicones ; Ultrasonography

Despite the high prevalence of chronic dermatitis and the accompanied intractable itch, therapeutics that specifically target itching have low efficacy. Increasing evidence suggests that TLRs contribute to immune activation and neural sensitization; however, their roles in chronic itch remain elusive. Here, we show that the RBL-2H3 mast cell line expresses TLR4 and that treatment with a TLR4 antagonist opposes the LPS dependent increase in mRNA levels of Th2 and innate cytokines. The pathological role of TLR4 activation in itching was studied in neonate rats that developed chronic itch due to neuronal damage after receiving subcutaneous capsaicin injections. Treatment with a TLR4 antagonist protected these rats with chronic itch against scratching behavior and chronic dermatitis.TLR4 antagonist treatment also restored the density of cutaneous nerve fibers and inhibited the histopathological changes that are associated with mast cell activation after capsaicin injection. Additionally, the expression of IL-1β, IL-4, IL-5, IL-10, and IL-13 mRNA in the lesional skin decreased after TLR4 antagonist treatment. Based on these data, we propose that inhibiting TLR4 alleviated itch in a rat model of chronic relapsing itch, and the reduction in the itch was associated with TLR4 signaling in mast cells and nerve fibers.

OBJECTIVE: To assess the value of applying MultiVane to liver T2-weighted imaging (T2WI) compared with conventional T2WIs with emphasis on detection of focal liver lesions. MATERIALS AND METHODS: Seventy-eight patients (43 men and 35 women) with 86 hepatic lesions and 20 pancreatico-biliary diseases underwent MRI including T2WIs acquired using breath-hold (BH), respiratory-triggered (RT), and MultiVane technique at 3T. Two reviewers evaluated each T2WI with respect to artefacts, organ sharpness, and conspicuity of intrahepatic vessels, hilar duct, and main lesion using five-point scales, and made pairwise comparisons between T2WI sequences for these categories. Diagnostic accuracy (Az) and sensitivity for hepatic lesion detection were evaluated using alternative free-response receiver operating characteristic analysis. RESULTS: MultiVane T2WI was significantly better than BH-T2WI or RT-T2WI for organ sharpness and conspicuity of intrahepatic vessels and main lesion in both separate reviews and pairwise comparisons (p < 0.001). With regard to motion artefacts, MultiVane T2WI or BH-T2WI was better than RT-T2WI (p < 0.001). Conspicuity of hilar duct was better with BH-T2WI than with MultiVane T2WI (p = 0.030) or RT-T2WI (p < 0.001). For detection of 86 hepatic lesions, sensitivity (mean, 97.7%) of MultiVane T2WI was significantly higher than that of BH-T2WI (mean, 89.5%) (p = 0.008) or RT-T2WI (mean, 84.9%) (p = 0.001). CONCLUSION: Applying the MultiVane technique to T2WI of the liver is a promising approach to improving image quality that results in increased detection of focal liver lesions compared with conventional T2WI.
Adult ; Aged ; Aged, 80 and over ; Artifacts ; Biliary Tract Diseases/diagnosis/radiography ; Female ; Humans ; Liver Diseases/*diagnosis/radiography ; Liver Neoplasms/*diagnosis/pathology/radiography ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Pancreatic Diseases/diagnosis/radiography ; Retrospective Studies

A 43-yr-old patient visited our department with intermittent chest pain he had suffered with for the past 2 months. Chest CT showed an egg shaped mass in the left chest wall. Local resection was performed for distinguishing the mass from a neurogenic tumor. The diagnosis was periosteal Ewing sarcoma of the rib. Since there was no evidence of metastasis based on the PET-CT, a 2nd operation was done with wide resection and thoracoplasty. The patient was then treated with combined chemotherapy. There has been no local recurrence for the last 1 year. The patient's age and tumor origin were distinct from the usual characteristics of Ewing's sarcoma. Periosteal Ewing's sarcoma of the rib has rarely been reported. We report here on a case of periosteal Ewing's sarcoma of the rib along with a review of the relevant medical literature.
Chest Pain ; Humans ; Neoplasm Metastasis ; Ovum ; Recurrence ; Ribs ; Sarcoma, Ewing ; Thoracic Wall ; Thoracoplasty ; Thorax

OBJECTIVE: To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. MATERIALS AND METHODS: We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. RESULTS: Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). CONCLUSION: Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.
Adult ; Aged ; Aged, 80 and over ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Endoscopy, Gastrointestinal ; Female ; Gastrointestinal Stromal Tumors/pathology/*radiography ; Humans ; Iohexol/analogs & derivatives/diagnostic use ; Logistic Models ; Male ; Middle Aged ; Neurilemmoma/pathology/*radiography ; Retrospective Studies ; Statistics, Nonparametric ; Stomach Neoplasms/pathology/*radiography ; Tomography, X-Ray Computed/*methods

PURPOSE: To evaluate the efficacy and safety of radiofrequency (RF) ablation for the treatment of small hepato-cellular carcinoma (HCC). MATERIALS AND METHODS: Forty-four patients with 51 HCCs underwent ultrasound guided RF ablation using ex-pandable needle electrodes and a monopolar RF generator. The patients were not considered suitable candidates for surgery or declined this option, and had no history of previous treatment. Mean tumor diameter was 2.5 cm (range, 1.0 -4.0 cm). Therapeutic efficacy was evaluated by means of three-phase helical computed tomography (CT) performed at least one month after the completion of ablation. The recurrence rate was also evaluated by follow-up CT at least four months after treatment. RESULTS: Using RF ablation, complete necrosis was achieved in 48 of 51 tumors (94%). Among 20 patients in whom follow-up CT was performed at least four months after ablation, one (5%) showed marginal recurrence and in another (5%) there was recurrence in remote liver parenchyma. We experienced neither procedure-re-lated mortality nor major complications which required specific treatment. Three minor complications (one small pneumothorax and two cases of intraperitoneal bleeding) occurred, but these disappeared without specific treatment. CONCLUSION: RF ablation using an expandable needle electrode showed a high rate of complete necrosis and a low rate of complications. The technique is therefore considered effective and safe for the local control of small HCCs.
Carcinoma, Hepatocellular* ; Catheter Ablation* ; Electrodes ; Follow-Up Studies ; Humans ; Liver ; Mortality ; Necrosis ; Needles ; Pneumothorax ; Recurrence ; Tomography, Spiral Computed ; Ultrasonography

A 42-years-old man was referred to our department due to his hemoptysis. Chest CT showed a cavitary lung lesion in the apical segment of the RUL and an anterior mediastinal mass. The patient underwent wedge resection for the cavitary lesion and complete resection for the mediastinal mass. The pathologic finding was Paragonimus Westermani infestation in both the lung and thymus. The abdomen CT taken postoperatively showed an inflammatory mass involving the transverse colon and a small nodular lesion around the descending colon, which strongly suggested paragonimiasis. Postoperatively, the patient took Praziquantel for 2 days and he was discharged without any complications. There was no evidence of recurrence for the last 2 years.
Abdomen ; Colon, Descending ; Colon, Transverse ; Hemoptysis ; Humans ; Lung ; Mediastinal Diseases ; Paragonimiasis* ; Paragonimus westermani ; Praziquantel ; Recurrence ; Thymus Gland ; Tomography, X-Ray Computed